Rehabilitative Therapy Business Must Pay $9.6 Million in Damages
- posted: Sep. 08, 2022
- Graft and Corruption, Fraud
A rehabilitative therapy business in Georgia, along with its founder, has been ordered to pay $9.6 million in damages for submitting nearly 800 false health care claims.
Case background
Middle Georgia Family Rehab LLC, along with owner/CEO Brenda Hicks, are jointly liable for 796 false claims submitted to TRICARE and Medicaid. The defendants were paid around $74,000 for their false claims.
A Georgia rehabilitative therapy business and its founder must pay $9.6 million for submitting almost 800 false health care claims, but can appeal the judgment before the remaining allegations in an occupational therapist's whistleblower suit are decided.
Joshua Walthour worked for the company for three months. He discovered that they were billing government healthcare programs for services never performed, and alleges Hicks altered patient records. He sued for violations of the False Claims Act and the Georgia False Medicaid Claims Act. The federal government intervened, as a plaintiff, in February 2021.
According to the lawsuit, the defendants fraudulently submitted claims for nearly seven years. They falsely billed under therapists who couldn’t perform or supervise the services, or who lacked qualifications and government authorization to provide those services. They also “upcoded” services to gain additional payments. As a result, the plaintiffs allege the company and Hicks received millions of dollars in payments they didn’t earn.
U.S. District Judge Tilman E. “Tripp” Self III, of the Middle District of Georgia, granted summary judgment for 796 claims against MGFR and Hicks. Judge Self also ruled that the parties would not have to wait until the end of litigation to certify for appeal: “The parties have a strong interest in exercising their right to appeal now, before the expenditure of time, effort, money, and energy litigating the remaining claims that may not, as a practical matter, be recoverable.”
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